Can Affect Lower Back Muscles and Cause Hamstring Spasms
Lower back muscles, including those like the quadratus lumborum, can be affected by paraspinal spasms. (Hospital for Special Surgery, 2024)
The spasms can cause these muscles to tighten or spasm, potentially pulling on the hamstring muscles.
This can lead to hamstring spasms and tightness, further contributing to pain and potential nerve irritation.
Entrapment of the Sciatic Nerve
Piriformis syndrome is a common condition where the piriformis muscle (located in the buttock) spasms and compresses the sciatic nerve. (Cedars-Sinai, 2025)
The sciatic nerve runs from the lower back down the back of the thigh and into the leg, making it vulnerable to compression by surrounding muscles.
If the paraspinal and hamstring spasms create enough tension on the piriformis muscle or surrounding tissues, it can lead to sciatic nerve entrapment. (Hospital for Special Surgery, 2024)
How acupuncture helps relieve sciatica
Acupuncture can help relieve sciatica pain by stimulating specific points on the body, which can trigger the release of endorphins, reduce inflammation, improve blood flow, and relax tight muscles that could be compressing the sciatic nerve. By modulating the nervous system and promoting the body’s natural healing processes, acupuncture can help alleviate pain and improve overall function. (Qin, Z. et al., 2015)
Releases endorphins
Acupuncture stimulates the nervous system, triggering the release of endorphins, the body’s natural painkillers.
Reduces inflammation
Acupuncture can help reduce inflammation in the area surrounding the sciatic nerve, which can contribute to pain and nerve irritation. (Natural Care Chiropractic, 2022)
Improves circulation
By increasing blood flow to the affected area, acupuncture can help deliver nutrients and oxygen to the sciatic nerve and surrounding tissues, promoting faster healing.
Relaxes tight muscles
Sciatica pain can be exacerbated by tight muscles compressing the nerve. Acupuncture can help relax these muscles, reducing pressure on the sciatic nerve and alleviating pain.
Regulates the nervous system
Acupuncture can help regulate the nervous system, positively impacting pain perception and overall well-being. (Qin, Z. et al., 2015)
Promotes regeneration
Some evidence suggests that acupuncture can promote sciatic nerve regeneration, potentially leading to long-term pain relief. (Natural Care Chiropractic, 2022)
Needling Types
Distal needling
Acupuncture can also involve using points that are further away from the site of pain, which can also help to reduce pain and inflammation.
Local needling
Points are also selected on or near the sciatic nerve’s path, which can help directly address the source of pain and inflammation. (Qin, Z. et al., 2015)
Holistic approach
Acupuncture is often viewed as a holistic approach to pain management, addressing the symptoms of sciatica and the underlying causes and imbalances in the body.
Injury Medical Chiropractic and Functional Medicine Clinic
As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.
Noonan, A. M., & Brown, S. H. M. (2021). Paraspinal muscle pathophysiology associated with low back pain and spine degenerative disorders. JOR spine, 4(3), e1171. https://doi.org/10.1002/jsp2.1171
Hospital for Special Surgery. (2024). Sciatica. https://www.hss.edu/condition-list_sciatica.asp
Qin, Z., Liu, X., Wu, J., Zhai, Y., & Liu, Z. (2015). Effectiveness of Acupuncture for Treating Sciatica: A Systematic Review and Meta-Analysis. Evidence-based complementary and alternative medicine: eCAM, 2015, 425108. https://doi.org/10.1155/2015/425108
Natural Care Chiropractic, D. M. F. (2022). Acupuncture for Sciatica Pain Relief. https://www.naturalcarechiropractic.com/post/acupuncture-for-sciatica-pain-relief
For individuals experiencing piriformis syndrome. Can knowing the causes and what it feels like help in diagnosis and treatment?
Managing Piriformis Syndrome
Piriformis syndrome is where spasms occur in the piriformis muscle located in the buttocks. These muscle spasms can cause pain and numbness in the buttocks and the back of the leg. (Cedars Sinai, 2022)
What Is It?
Piriformis syndrome is an irritation of the sciatic nerve from the piriformis muscle. Although the piriformis muscle is small compared to other muscles around the hip and thigh, it supports the hip joint’s external rotation or turning out. The sciatic nerve supplies the lower extremities with motor and sensory functions. The piriformis tendon and sciatic nerve cross each other behind the hip joint in the deep buttock. Both are about one centimeter in diameter. The piriformis muscle spasms can irritate the sciatic nerve, causing sciatica symptoms. (Cedars Sinai, 2022)
Triggers
A piriformis syndrome diagnosis means the piriformis tendon binds or spasms around the sciatic nerve, causing irritation and symptoms. Many doctors and specialists support the theory that when the piriformis muscle and its tendon tighten, this can cause compression and pinch the nerve. This can decrease blood circulation and irritate the nerve due to pressure. (Cass S. P. 2015) Many doctors also believe that piriformis syndrome occurs from anatomic variation of the muscle and tendon. It is thought this muscle-tendon variation irritates the nerve in some, leading to sciatica symptoms.
How It Feels
Common signs and symptoms experienced include (Cass S. P. 2015)
Pain in the buttocks.
Pain behind the hip.
Electric shock pains traveling down the back of the lower extremity.
Numbness in the lower extremity.
Tenderness with pressure that often causes pain when sitting.
Some develop symptoms abruptly, while others gradually increase in symptoms in the back of their thighs.
Most who are diagnosed with piriformis syndrome are generally active individuals who experience increasing difficulty with certain types of physical activity.
Testing
There are no specific tests that accurately diagnose piriformis syndrome. Doctors will order tests, including MRI and nerve conduction studies. Because it can be difficult to diagnose, there are likely many misdiagnosis cases. This means that some with the condition don’t have a piriformis diagnosis. In addition, some with vague hip pain may receive this diagnosis even if they don’t have the condition. (Cass S. P. 2015) An injection is often administered into the piriformis muscle when the diagnosis is uncertain. (Jankovic D. et al., 2013) Performing an injection can help determine the specific location of the discomfort. When an injection is given into the piriformis muscle or tendon, it is administered by ultrasound guidance to ensure the needle delivers medication to the correct location. (Bardowski E. A., and Byrd J. W. T. 2019)
Differential Diagnosis
Some other conditions with buttock pain can have similar symptoms. Other causes can include:
Radiculopathy/Sciatica
Herniated discs
Hip bursitis
Spinal stenosis
The diagnosis of piriformis syndrome is given when these diagnoses are eliminated as possible causes of pain.
Treatment
Managing piriformis syndrome is quite general, and it is often difficult to recover from. Common treatment and management suggestions include the following. (Jankovic D. et al., 2013)
Rest
Avoiding activities that cause symptoms for at least a few weeks.
Physical Therapy
Focuses on stretching and strengthening the hip rotator muscles.
Anti-inflammatory Medication
To decrease inflammation around the tendon.
Deep Massage
Used to relax the piriformis muscle and help release the compressed nerve.
Cortisone Injections
It can help decrease inflammation and swelling.
Botulinum Toxin Injection
It can paralyze the piriformis muscle to reduce pain and discomfort.
In severe cases, surgery can be performed to loosen the piriformis tendon, known as a piriformis release (Cass S. P. 2015). This surgical procedure is recommended when conservative treatments have been tried for at least six months and other causes of pain have been evaluated and ruled out. Recovery takes several months.
The goal of managing piriformis syndrome is to improve the range of motion and flexibility around the hip and diminish inflammation around the sciatic nerve. Working with a professional chiropractic team can help relieve pain, return individuals to normal function, and expedite healing. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a customized treatment program through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Piriformis Syndrome Treatment Chiropractor
References
Cedars Sinai. Sinai, C. (2022). Piriformis syndrome. https://www.cedars-sinai.org/health-library/diseases-and-conditions/p/piriformis-syndrome.html
Cass S. P. (2015). Piriformis syndrome: a cause of nondiscogenic sciatica. Current sports medicine reports, 14(1), 41–44. https://doi.org/10.1249/JSR.0000000000000110
Jankovic, D., Peng, P., & van Zundert, A. (2013). Brief review: piriformis syndrome: etiology, diagnosis, and management. Canadian journal of anaesthesia = Journal canadien d’anesthesie, 60(10), 1003–1012. https://doi.org/10.1007/s12630-013-0009-5
Bardowski, E. A., & Byrd, J. W. T. (2019). Piriformis Injection: An Ultrasound-Guided Technique. Arthroscopy techniques, 8(12), e1457–e1461. https://doi.org/10.1016/j.eats.2019.07.033
Muscle cramp and muscle spasm: Three types of muscles make up the body.
Cardiac muscle makes up the heart.
Smooth muscle cells line the blood vessels, gastrointestinal tract, and organs.
Skeletal muscles attach to the bones and are used for voluntary movements.
A muscle spasm happens when skeletal muscle contracts and does not go back to its relaxed state. Spasms are forceful and involuntary. A muscle spasm that sustains/continues is a muscle cramp. The leg muscles, especially the quadriceps/thigh, hamstrings/back of the thigh, and gastrocnemius/calves, are prone to cramping, but any skeletal muscle can cramp. Charley horse is another name for a muscle cramp.
Causes
There can be a variety of causes for muscle cramps. This includes:
Physical exertion in hot weather
Overexertion
Dehydration
Electrolyte imbalance
Physical deconditioning
Certain medications and supplements could contribute to muscle cramping.
They can interfere with electrolyte levels, contribute to the breakdown of muscle tissue, and/or interfere with blood circulation. Any medication-related muscle cramping should be reported to a doctor.
Night Cramping
Night cramping, especially in the calves, is common and affects up to 60% of adults. Women are more prone to night-leg cramps than men. They are also common with age and a common contributor to insomnia. Muscle fatigue and nerve dysfunction are believed to be a factor. Management remedies include:
Stretching
Self-Massage
Topical muscle pain ointments/creams
Ice therapy
Remedies and Treatment
The majority of cramps resolve on their own within a few minutes without treatment.
It is recommended that as soon as a cramp begins, stop the activity.
Stretch and massage the area,
Hydrate with water and, if necessary healthy sports drink to replenish sodium, vitamins, electrolytes, and more.
Apply heat to help relax the muscle.
Apply an ice pack.
Nonsteroidal anti-inflammatory medications (NSAIDs) can help if the pain is substantial.
Consult a doctor if cramps are severe or are recurring often.
Prevention
Strategies for reducing the risk include:
To vary exercise routines
Maintain proper hydration
Maintain proper levels of electrolytes. Sodium and potassium are lost during physical activity, especially in the heat and with consistent sweating.
Regular Stretching
Warm-up with a quick jog or quick walk before stretching the body.
Body Composition
Insulin and the body
Insulin assists the transport and storage of energy glucose to cells, tissues, and organs. These include the body’s glucose storage like the skeletal muscles and liver. Once the blood sugar returns to a base level as the glucose is absorbed, the pancreas begins producing glucagon instead of insulin. Glucagontells the liver to release the stored sugar, which typically happens between meals. What happens to the body when eating too much sugar and carbohydrates than the glucose-storing organs can handle?
Individuals with Type 1 diabetes have a pancreas that does not produce insulin. Type 1 diabetics need to control their glucose levels with lifelong insulin therapy.
With Type 2 diabetes, the pancreas ends up producing insulin through frequent outbursts. When this starts to happen more than normal, the cells eventually lessen their insulin sensitivity. The body becomes numb to the signaling that there is excess blood sugar in the body. This is what happens in individuals with insulin resistance or Type 2 diabetes. This type of diabetes can be managed or prevented with diet adjustments.
References
AAOS: “Muscle Cramps.” Jun. 2017.
American Academy of Orthopedic Surgeons: “Muscle Cramp.”
American Academy Physician: “AAN Recommendations on Symptomatic Treatment for Muscle Cramps.”
American Family Physician: “Nocturnal Leg Cramps.”
American Osteopathic Association: “Muscle Cramp – A Common Pain.”
Journal of the American Academy of Orthopedic Surgeons: “The Athlete With Muscular Cramps: Clinical Approach.”
National Cancer Institute: “Muscle Types.”
National Institute of Mental Health: “What Is Generalized Anxiety Disorder?”
Tight and sore hamstrings commonly occur during workout and exercise, but can just as easily result from a fall or other accident. Individuals usually experience pain located at the back of the thigh with associated weakness along with the feeling of the muscles becoming tighter and a consistent soreness. Consistent tightness in the back of the legs is not only uncomfortable but can also make movement difficult.
Many individuals stretch every day, do yoga, etc trying to relieve hamstring tension, with short-term relief only to have the tightness return. This is frustrating but more importantly, indicates that the problem might not have to do with the muscle�s length. There could be an underlying issue that needs to be identified and addressed. A chiropractic approach will diagnose and treat the root of the pain, not just the symptoms.
Hamstring/s Tightness
The hamstring is not a single string. It is a set of three muscles that run along the back of the thigh. The muscles allow for the bending of the leg at the knee. With a hamstring strain, one or more of these muscles can become overloaded and can start to tear. Strains often happen during activities that involve running, jumping, and/or sudden stopping and starting. This is where stretching doesn’t help, however, a chiropractic adjustment can help.
Weak Muscle Compensation
One possible cause for the tightness has to do with various related muscles and not the hamstrings themselves. Muscles that typically stabilize and facilitate movement could be too weak or are not functioning properly. What usually happens is that the muscles that are active have to work harder to compensate for the others that are not working/functioning properly.
The tension in the hamstrings can be alleviated through chiropractic exercises/stretches that activate the stabilizing muscles and get the circulation moving to promote strength and take the pressure off the hamstrings.
These muscle weaknesses can be caused by spinal misalignments that pull the body in an awkward fashion, throwing the body’s balance off. Each condition feeds the other as the hamstrings have to work harder, the body leans to the side that doesn’t cause pain, causing the spine to shift out of alignment and so begins the awkward body shifting to avoid the pain cycle. A chiropractic adjustment will restore balance and stability to the entire body.
A Pelvic Tilt
Pelvic tilt could be a contributing factor for tightness and soreness. This comes from:
Poor posture
Lack of physical activity
Weight gain
These factors can cause the pelvis to shift forward ever so slightly. But just that slight tilting could be pulling on the hamstrings. In order to rectify the tilt, exercise is recommended, and chiropractic manipulation to realign any spinal shifting.
Sciatic Irritation
Another issue is sciatic nerve irritation that could mimic tightness in the muscles. The sciatic nerve runs down the back of the leg and the irritation could make the hamstring appear to be tight. This is where stretching the hamstrings can worsen the condition by irritating the sciatic nerve, causing inflammation.
The sciatic nerve could also be experiencing irritation from spinal misalignment. A vertebral disc could be bulging or herniated. This could inflame the nerve root. A bone spur or inflamed joint could be impinging/compressing on the nerve root exits.
A chiropractic treatment plan will relieve the tension being placed on the nerve and allow for proper blood circulation and transmission of signals without interruptions. Talk to a chiropractor about an examination to identify the exact root causing the discomfort.
Advanced Chiropractic Treatment
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Hoskins, Wayne, and Henry Pollard. �Hamstring injury management–Part 2: Treatment.��Manual therapy�vol. 10,3 (2005): 180-90. doi:10.1016/j.math.2005.05.001
Pilates or yoga can work wonders and always stretch before physical exercise.
Get fit – no regular physical activity can lead to serious conditions and possibly chronic pain.
Exercise benefits all, even some light walking around the neighborhood is enough. Just get moving!
Playing a sport could be a way to keep active. Remember, in order for any exercise to work is that it is done regularly.
Strength training is important, just as its name implies strength training builds muscle and reduces muscle imbalances.
It�s never too late to increase strength and flexibility.
Look at activities that you and your friends/family can enjoy and make doing them a regular thing.
A�chiropractor�is the ideal�medical professional to consult with for any unexplained pain in the musculoskeletal system. They are highly qualified professionals that their specialty is treating conditions like lower back pain and they are very affordable. If you or a loved one have pain in the lower back, give us a call. We�re here to help!
Understand *FOOT PRONATION* & How to Correct it with Orthotics | El Paso, TX (2019)
Foot pronation is the natural movement that occurs during foot landing while walking or running. Foot pronation also occurs while standing, and in this instance, it is the amount in which the foot rolls inward toward the arch. Foot pronation is normal, however, excessive foot pronation can cause a variety of health issues, including bad posture. The following video describes the 5 red flags of excessive foot pronation, which can ultimately affect a person’s overall health and wellness. Dr. Alex Jimenez can help diagnose and treat excessive foot pronation. Patients recommend Dr. Alex Jimenez and his staff as the non-surgical choice for excessive foot pronation health issues.
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